This systematic review aimed to examine the associations between health-related outcomes and the built environment (BE) characteristics of compact metropolitan cities in Korea using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) framework. Searching the three Korean academic databases and PubMed, two independent reviewers identified 27 empirical articles published between 2011 and 2016. Data extracted for review included the study characteristics, the variables and measurement methods related to the BE and health-related outcomes, and the findings on the associations between the BE characteristics and health-related outcomes. Vote counting was used to assess the consistency of associations and the direction of associations between the BE characteristics and health-related outcomes. All of the reviewed studies used cross-sectional designs. The objective BE qualities were commonly examined. The BE characteristics associated with health-related outcomes in the reviewed articles included land use, street environment, transportation infrastructure, green and open spaces, and neighborhood facilities. Street environment, transportation infrastructure, and green and open spaces had consistent positive associations with physical health. Mixed land use and neighborhood facilities, however, had inconsistent associations with physical health. Generally, insufficient findings were reported in the association between the BE characteristics and mental and social health. The accessibility of the BE in a compact urban environment was the prominent attribute related to health promotion, health challenges, and health equity. An international comparative analysis of compact cities with different urban contexts and scale is required. Interdisciplinary urban health strategies are recommended based on the associations between the BE characteristics and health-related outcomes.
Cycling provides opportunities to promote healthy and sustainable cities. However, few studies examine cyclists’ perceived attributes of a bicycle-friendly environment in relation to compact urban contexts. This study explored the attributes of perceived bikeability and urban context related to the cycling experience in Seoul, Korea. Purposive sampling with public recruitment and a snowball technique was used to recruit twenty-two cyclists and three bicycle-related community service providers from a bikeable environment. Qualitative multi-methods, including semi-structured interviews and bicycle tours with a GPS device, were adopted. The main themes of perceived bikeability were derived through thematic analysis. Cyclists perceived the attributes of a bicycle-friendly physical environment as essential components of bikeability. In urban environments where cycling is not yet recognized as the main transportation mode, internal conflict among cyclists and external conflicts between cyclists and other transportation users were evident. A supportive community system included developing an appropriate environment, providing information, and expanding riding opportunities. A bicycle-friendly culture accumulated over a long period influenced the initiation and maintenance of cycling and contributed to a more bikeable community environment. Cyclists’ attitude, behaviors, and perceived environment differed according to purpose. Policy, system, and environmental changes are required to promote cycling in compact urban contexts.
Background and Objectives: Walking enhances the health, quality of life, and independence of older adults. However, a global decline in urban walking necessitates a re-evaluation of segmented, quantitative approaches to policies and theoretical frameworks in geriatric medicine for promoting walking among older adults. This study conceptualized the perceptions, experiences, and behaviors regarding walking, from a health promotion perspective, among older urban adults. Research Design and Methods: Pedestrian-friendly communities were explored for older adults in Seoul, South Korea, using a grounded theory. Thirty-eight older adults actively engaged in walking were recruited between July and December 2020. A qualitative multimethod approach was used, and the collected data were analyzed using open, axial, and selective coding, with axial coding integrating textual and spatiobehavioral information. Results: The open-coding process yielded 92 concepts, 47 subcategories, and 19 categories. Using axial and selective coding principles, a conceptual framework was developed to explain how walking shaped the daily lives of older urban adults and provided multidimensional health benefits. Walking perception attributes were characterized by “embodied subjectivity as a healthy older adult,” “autonomy of movement,” and “walking as a way to enrich or sustain life.” Active walking facilitated interactions between older adults and their neighborhood environment within the context of compact and accessible urban living. Discussion and Implications: A healthy and age-friendly community encourages interactions between older adults and their neighborhood environment by providing opportunities for daily walking for several purposes, such as providing a sense of autonomy, increasing health-promoting behaviors, and creating a sense of community.
Introductions: An increasing number of countries are adopting the tobacco endgame goal. High levels of public support can accelerate momentum towards implementing tobacco endgame policies. We aimed to conduct a systematic review of public support for tobacco endgame policies and to examine the geographical distribution of studies, support among key populations (adolescents and young adults, people who smoke), and the association between survey design and support. Aims and Methods: We searched Embase, PubMed, Scopus, Web of Science, and Google Scholar for studies published from 2013 onwards. Google was used to search the gray literature. The reference lists of included articles were hand-searched. Studies were included if they reported the proportions of people supporting one or more endgame policies. Risk of bias was assessed using the JBI checklist for prevalence studies. Results: Forty-seven articles were included. Aotearoa/New Zealand and the United States were the countries with the most studies (n = 11, respectively). Three-level meta-analyses showed the highest support for mandating a very low nicotine content in tobacco products (76%, 95% CI: 61% to 87%). Meta-regressions were performed to assess the associations of population subgroup and survey design with support levels. The level of support was lower among people who smoke compared to the general population (β range: −1.59 to −0.51). Support for some policies was lower when neutral or don’t know response options were included. Conclusions: Public support for most tobacco endgame policies was high. Implications: Assessing public support can assist with progressing tobacco endgame policies. Policies that are widely supported by the public may be more politically feasible to implement. Qualitative studies and trial studies can further inform communication and implementation strategies for tobacco endgame policies.
31 March 2022 in Korean Journal of Health Education and Promotion
Objectives: This study aimed to conceptualize the walking experience of urban older adults from the perspective of health promotion. Methods: The research design applied a grounded theory approach. Theoretical sampling was implemented until theoretical saturation was reached, and 33 older adults living in a pedestrian-friendly community in Seoul were recruited for the study. Data were collected only at the first stage of social distancing between July and December 2020. This study employed qualitative multi-methods that combined in-depth interviews and field observation. The collected data were analyzed through open, axial, and selective coding, while text and spatial information were integrated during axial coding. Results: The open coding resulted in 83 concepts, 35 subcategories, and 14 categories, which were reconstructed according to the coding paradigm structure for axial coding. The walking experience phenomenon among urban older adults was reflected through the following: “subjectivity as a healthy older adult,” “autonomy of movement,” and “diverse range of daily experiences in terms of walking.” This phenomenon was linked to multidimensional health promotion by facilitating interactions between older adults and the environment in the context of urban old adults. Conclusion: A healthy and age-friendly community should move toward promoting the interaction between older adults and the environment by increasing the frequency of walking for various purposes.
31 December 2018 in Korean Journal of Health Education and Promotion
Objectives: This study aimed to examine systems behavior of urban walking by analyzing a dynamic structure in Seoul, South Korea. Methods: As a systems thinking approach to urban walking and health promotion, we developed a Casual Loop Diagram based on literature review and expert consultation. The reviewed literature included: 1) qualitative studies that explores the experiences of urban walkers in Seoul; 2) a systematic review study on the built environmental factors related to walking; 3) policy research reports related to urban walking in Seoul. Results: The feedback structure for urban walking was related to the three urban environments (safety & walking environment, socioeconomic environment, and public transportation environment), and was characterized by a trade-off consisting of eight reinforcing loops and four balancing loops. Conclusions: The policies for a walkable city require multi-sectoral cooperation in order to change the causal loop structure related to the decline of walking. Therefore, it is necessary to establish legal and institutional conditions so that multi-sectoral and multidisciplinary approaches are possible.